The proposed research investigate the mechanisms underlying neurologic impairment and social adjustment and role performance in alcoholics. Specifically, the type and severity of liver disease in alcoholics will be evaluated histologically and biochemically with respect to magnitude and specific manifestation of neurologic deficit measured by neuropsychological test, clinical neurologic examination and in a subset of cases, by magnetic resonance imaging. These studies will clarify the extent to which an hepatic encephalopathy and the particular intrinsic pathologic concomitants of hepatic disease determine the neurologic sequelae of alcoholism. A second study will evaluate the effects of orthotopic hepatic transplantation on recovery of neurologic impairment and improvement in psychosocial adjustment of alcoholics. These results will provide important new information regarding whether concerted medical management of alcoholic liver disease can augment the rehabilitation of alcoholics.